Medicare has shown that attempts at "pay for performance" — paying for paperwork showing compliance with quality — do not incentivize doctors. Surprisingly, New York City recently announced a similar proposal, which promises little better. Fortunately, a key alternative to these unrealistic ideas is emerging.
With the Affordable Care Act's emphasis on clinical quality, doctors in the American Medical Association, American College of Surgeons, the American Board of Internal Medicine and other medical associations have begun to show that realistic cost control can be provided by improving clinical decisions. Through providing the right care and eliminating unnecessary care, doctors can have reliable, relatively realistic incomes; Congress will realize savings; and we can heave a final sigh of relief upon the demise of this annual charade.
James Burdick is professor of surgery at Johns Hopkins University School of Medicine. His email is jburdic1jhmi.edu
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